Provider Demographics
NPI:1801332358
Name:CRANE, REBECCA LOUISE (PSYD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LOUISE
Last Name:CRANE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 E CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-3644
Mailing Address - Country:US
Mailing Address - Phone:508-647-1644
Mailing Address - Fax:508-809-7467
Practice Address - Street 1:154 E CENTRAL ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-3644
Practice Address - Country:US
Practice Address - Phone:508-647-1644
Practice Address - Fax:508-809-7467
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10415103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist